Your chances of living to talk about your heart attack increase greatly if you listen when your body is trying to tell you something. Although some heart attacks occur without any symptoms at all, any one of the following symptoms is a ‘strong warning that you are probably having a heart attack:(i) Uncomfortable pressure —not necessarily pain — in yourhest, most often experienced as a deep central discomfort (or feeling of fullness or squeezing) below the breastbone. This kind ofcrushing pain or heaviness in the middle of the chest is the mostcommon symptom of a heart attack (About a quarter of patients how-ever will not experience this sensation). If it lasts more than a few minutes, or if it subsides when you rest but increases with activity, that increases the likelihood that what you are experiencing is a restriction of blood flow to the heart muscle.(ii) Chest pain that radiates to the jaw, neck, back, shoulder or arm. In some patients, the pain is experienced primarily, or even exclusively, in other locations. (iii) Chest discomfort that’s accompanied by light-headedness, nausea, sweating or shortness of breath.Chest pain is unlikely to be a heart attack if it is — “Stabbing” pain that can be localized to one small spot on the chest (about the size of a coin). For instance, a feeling as if a pencil is being poked into the chest for an instant.Pain/discomfort that lasts for less than 30 seconds.Pain that is felt exclusively” in the region of the heart itself (that is the left side of the chest).If you experience any of the main symptom syndromes, immediately call for an ambulance to take you to a hospital, then take half a tablet of soluble aspirin (even if you already are on an aspirin regimen), either chewing it or allowing it to dissolve under your tongue. This self-administered aspirin therapy can in itself cut the risk of death by 40 per cent!Though an ambulance is often the fastest and safest way to get to a hospital, a friend or relative can sometimes drive you there faster. Delay in seeking expert medical attention is the most critical risk factor when a heart attack is taking place: a delay of even one to two hours can mean the difference between a small heart attack and a big one or even the difference between life and death. Doctors today have powerful drugs to dissolve the clots in the arteries that are causing heart muscle to die. But they work best if they are administered within an hour after the first symptoms begin; after six hours, they make little difference as most of the damage is irreversible by then. That is why cardiologists say, “Time is Muscle.” So, don’t stop to rationalize away the warning symptoms you’re experiencing as something else. More don’ts:Don’t waste time going to your family doctor’s clinic or to a small nursing home. What you need is a hospital with an 1CCU (Intensive Cardiac Care Unit) which is geared to provide specialized emergency care.(Ideally, you need to practise Early Cardiac Care: if you are at known risk for heart disease, get to know and keep a list of hospitals in your areas of residence and/or work, in advance. Also keep a list of phone numbers: ambulance services, friends, relatives).Don’t try to drive yourself to the hospital, or to go by foot, cab, bus or train.And remember:Youth is no guarantee against a heart attack. Even if you are in your 20s, a long episode of chest pressure needs to be promptly evaluated by an expert to exclude the possibility of a heart problem, even a heart attack.Many heart attacks occur in those without any of the traditional risk factors for heart disease. So even if you have no history of high blood cholesterol or hypertension, do not ignore prolonged episodes of chest discomfort.Some heart attacks are signalled by atypical symptoms, which may fun the gamut from heartburn to sudden, recurrent vomiting. Complaints that arise with activity and subside with rest often also serve as early warning signs of a heart attack.*54\332\2*